FETAL MACROSOMIA AND DIABETES MELLITUS

Link to Fetal Macrosomia

Maternal diabetes induces accelerated fetal growth in insulin receptive tissue (1). The brain is not insulin sensitive and therefore cephalic growth is not affected, but somatic growth of the fetal abdomen, soft tissues and other organs are affected. There the macrosomic fetus has an asymmetrically large body in relation to head size.

• Brans et al (2):
  At equal birth weight, neonatal skinfold thicknesses of non-diabetic women and gestational diabetic mothers were comparable, although thicker than normal. Neonates of insulin dependent diabetic mothers had a greater skinfold thickness.
• West and Brans (3):
  Neonates of diabetic mothers that weighed between 1700-5000 g, had more subcutaneous fat than their nondiabetic peers.
• Abramowicz et al (1):
  Cheek-to-cheek diameter is large in large for gestational age fetuses of diabetic mothers. The cheek-to-cheek/BPD ratio is significantly larger than controls.
  
  

REFERENCES

1. Abramowicz JS, Sherer DM, Bar-Tov E et.al. The cheek-to-cheek diameter in the ultrasonographic assessment of fetal growth. Am J Obstet Gynecol 1991;165:846-852.
2. Brans YW, Shannon DL, Hunter MA. Maternal diabetes and neonatal macrosomia. II. Neonatal anthropometric measurements. Early Hum Dev 1983;8:297-305.
3. West DL, Brans YV. Maternal diabetes and neonatal macrosomia. Dynamic skinfold thickness measurements. Am J Perinatol 1986;1:9-12.